Former NHS Chief Calls For Pause On Organisational Changes

By on 05/08/2015 | Updated on 25/09/2020
According to UK government targets, 95% of A&E patients should be treated within four hours

Sir David Nicholson, who was chief executive of the UK’s National Health Service (NHS) for eight years, has called for the government to give its health services a break from organisational reforms.

Speaking in an exclusive interview with Global Government Forum, Nicholson said: “I think the NHS needs a period of little or no organisational change over the next few years so that people can focus on the real issues – which is developing a sustainable NHS, improving services for patients, making services safer – and not to be endlessly speculating about their own positions and reorganisations.”

Asked whether he would want the government to stop re-organising the NHS, he said: “Yes, absolutely. Sometimes you have to change the way things go. I’m not saying you should keep everything the same all the time, but you have to be very, very careful and circumspect.”

Under the coalition government, which was in power between May 2010 and May 2015, the 2012 Health and Social Care Act saw a major restructuring of how the NHS is funded.

Nicholson managed the reforms for crusading Tory health secretary Andrew Lansley, who eventually fell out with NHS staff and was moved to the job of leader of the Commons by prime minister David Cameron.

Nicholson said that “politicians always think reorganisations are cost-free and won’t have any effect on service, but that’s not true.”

Reorganisations are, he added, “potentially quite dangerous, because they take people’s eye off the ball: if you’re constantly being reorganised and you’re not sure what job you’re going to have in 12 months; where you’ll be; who you’ll be working with; coupled with the general discussion and speculation about what’s going to happen, you’re likely to focus on yourself, look after your own interest, instead of trying to improve services for patients.”

Healthcare think-tank The King’s Fund concluded in a report published this February that reforms by the coalition “resulted in top-down reorganisation of the NHS which has been distracting and damaging.”

The coalition’s reforms followed a long period of changes under Labour, which was in government between 1997 and 2010.

During those years, many of the NHS’s institutions were abolished and replaced with new structures. In 2002, district health authorities were replaced by strategic health authorities (SHAs) and primary care trusts (PCTs). Just ten years later, both PCTs and SHAs were abolished by the coalition government.


See also: our full interview with Sir David Nicholson

About Winnie Agbonlahor

Winnie is news editor of Global Government Forum. She previously reported for Civil Service World - the trade magazine for senior UK government officials. Originally from Germany, Winnie first came to the UK in 2006 to study a BA in Journalism & Russian at the University of Sheffield. She is bilingual in English and German, and, after spending an academic year abroad in Russia and reporting for the Moscow Times, Winnie also speaks Russian fluently.

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